This project is intended to elucidate the conditions contributing to myocardal injury, ventricular malfunction or arrhythmias in chronic alcoholism. Studies in animal models will supplement the human studies to control some of the variables not amenable to regulation in man. An important characteristic of long-term alcoholics in terms of the cardiovascular system is the presence of a preclinical abnormality of ventricular performance with a high degree of prevalence in males and low incidence in females. The course of this preclinical phenomenon is not known in patients who continue to ingest alcohol in intoxicating amounts or those who become abstinent. It is proposed to explore the role of the sympathetic nervous system in the development of cardiac pathophysiology. Plasma norepinephrine and epinephrine will be assessed at rest and during stress in several groups of alcoholic patients who are acutely alcoholic, post-withdrawal, or abstinent for comparison with age and sex-matched controls. Since most alcoholics with heart disease use cigarettes we wish to determine the potential additive effects of tobacco use in an animal model. In appropriate groups of animals we will examine variations in catecholamine metabolism, alterations of myocardial function, rhythmicity and collagen accumulation.